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Lin X, Du Z, Liu Y, Hao Y. The short-term association of ambient fine particulate air pollution with hypertension clinic visits: A multi-community study in Guangzhou, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 774:145707. [PMID: 33611009 DOI: 10.1016/j.scitotenv.2021.145707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The association of ambient fine particulate pollution with daily outpatient clinic visits (OCV) for hypertension in China remains to be investigated. OBJECTIVES This study aimed to examine short-term impacts of exposure to fine particulate matter of aerodynamic diameter < 2.5μm (PM2.5) on daily OCV for hypertension, using a large-scale multi-center community database in Guangzhou, one of the most densely-populated cities in Southern China. METHODS We collected a total of 28,548 individual records of OCV from 22 community healthcare facilities in Guangzhou from January 1st to May 7th 2020. Hourly data on air pollutants and daily information on meteorological factors were obtained. According to the World Health Organization air-quality guidelines, daily excessive concentration hours (DECH) was calculated. PM2.5 daily mean, hourly-peak concentration and DECH were used as the exposure variables. Based on a case-time-control design, the Cox regression model was applied to evaluate the short-term relative risks (RR) of daily OCV for hypertension. Sensitivity analyses were conducted, with nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone being adjusted. RESULTS Daily mean and hourly-peak of PM2.5 were significantly associated with daily OCV for hypertension, while weaker associations were observed for DECH. The estimated RRs at lag day 0 were 1.039 (95% confidence interval [CI]: 1.037, 1.040), 1.851 (95%CI: 1.814, 1.888), and 1.287 (95%CI: 1.276, 1.298), respectively, in association with a 1-unit increase in DECH, daily mean, and hourly-peak concentration of PM2.5. For the lagged effect, lag4 models estimated the greatest RRs for PM2.5 DECH and hourly-peak, whereas a lag2 model produced the highest for PM2.5 daily mean. DISCUSSION This study consolidates the evidence for a positive correlation between ambient PM2.5 exposure and risks of hypertensive OCV. It also provides profound insight regarding planning for health services needs and establishing early environmental responses to the worsening air pollution in the communities.
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Affiliation(s)
- Xiao Lin
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Zhicheng Du
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Yu Liu
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology & Health Information Research Center & Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China; Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
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Azimi P, Stephens B. A framework for estimating the US mortality burden of fine particulate matter exposure attributable to indoor and outdoor microenvironments. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:271-284. [PMID: 30518794 PMCID: PMC7039807 DOI: 10.1038/s41370-018-0103-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/25/2018] [Accepted: 11/12/2018] [Indexed: 05/21/2023]
Abstract
Exposure to fine particulate matter (PM2.5) is associated with increased mortality. Although epidemiology studies typically use outdoor PM2.5 concentrations as surrogates for exposure, the majority of PM2.5 exposure in the US occurs in microenvironments other than outdoors. We develop a framework for estimating the total US mortality burden attributable to exposure to PM2.5 of both indoor and outdoor origin in the primary non-smoking microenvironments in which people spend most of their time. The framework utilizes an exposure-response function combined with adjusted mortality effect estimates that account for underlying exposures to PM2.5 of outdoor origin that likely occurred in the original epidemiology populations from which effect estimates are derived. We demonstrate the framework using several different scenarios to estimate the potential magnitude and bounds of the US mortality burden attributable to total PM2.5 exposure across all non-smoking environments under a variety of assumptions. Our best estimates of the US mortality burden associated with total PM2.5 exposure in the year 2012 range from ~230,000 to ~300,000 deaths. Indoor exposure to PM2.5 of outdoor origin is typically the largest total exposure, accounting for ~40-60% of total mortality, followed by residential exposure to indoor PM2.5 sources, which also drives the majority of variability in each scenario.
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Affiliation(s)
- Parham Azimi
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL, USA.
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Jones RR, Boscoe FP, Medgyesi DN, Fitzgerald EF, Hwang SA, Lin S. Impact of geo-imputation on epidemiologic associations in a study of outdoor air pollution and respiratory hospitalization. Spat Spatiotemporal Epidemiol 2019; 32:100322. [PMID: 32007283 DOI: 10.1016/j.sste.2019.100322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/02/2019] [Accepted: 12/09/2019] [Indexed: 11/13/2022]
Abstract
Imputation of missing spatial attributes in health records may facilitate linkages to geo-referenced environmental exposures, but few studies have assessed geo-imputation impacts on epidemiologic inference. We imputed patient Census tracts in a case-crossover analysis of fine particulate matter (PM2.5) and respiratory hospitalizations in New York State (2000-2005). We observed non-significantly higher PM2.5 exposures, high accuracy of binary exposure assignment (89 to 99%), and marginally different hazard ratios (HRs) (-0.2 to 0.7%). HR differences were greater in urban versus rural areas. Given its efficiency and nominal influence on accuracy of exposure classification and measures of association, geo-imputation is a candidate method to address missing spatial attributes for health studies.
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Affiliation(s)
- Rena R Jones
- School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States.
| | - Francis P Boscoe
- School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States; New York State Department of Health, Cancer Registry, Riverview Center, Menands, NY 12204, United States
| | - Danielle N Medgyesi
- Kelly Government Solutions, 6101 Executive Blvd., Rockville, MD 20852, United States
| | - Edward F Fitzgerald
- School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
| | - Syni-An Hwang
- School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States; New York State Department of Health, Center for Environmental Health, Corning Tower, Empire State Plaza, Albany, NY 12237, United States
| | - Shao Lin
- School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY 12144, United States
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4
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Zhang W, Lin S, Hopke PK, Thurston SW, van Wijngaarden E, Croft D, Squizzato S, Masiol M, Rich DQ. Triggering of cardiovascular hospital admissions by fine particle concentrations in New York state: Before, during, and after implementation of multiple environmental policies and a recession. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 242:1404-1416. [PMID: 30142556 DOI: 10.1016/j.envpol.2018.08.030] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Previous studies reported triggering of acute cardiovascular events by short-term increasedPM2.5 concentrations. From 2007 to 2013, national and New York state air quality policies and economic influences resulted in reduced concentrations of PM2.5 and other pollutants across the state. We estimated the rate of cardiovascular hospital admissions associated with increased PM2.5 concentrations in the previous 1-7 days, and evaluated whether they differed before (2005-2007), during (2008-2013), and after these concentration changes (2014-2016). METHODS Using the Statewide Planning and Research Cooperative System (SPARCS) database, we retained all hospital admissions with a primary diagnosis of nine cardiovascular disease (CVD) subtypes, for residents living within 15 miles of PM2.5 monitoring sites in Buffalo, Rochester, Albany, Queens, Bronx, and Manhattan from 2005 to 2016 (N = 1,922,918). We used a case-crossover design and conditional logistic regression to estimate the admission rate for total CVD, and nine specific subtypes, associated with increased PM2.5 concentrations. RESULTS Interquartile range (IQR) increases in PM2.5 on the same and previous 6 days were associated with 0.6%-1.2% increases in CVD admission rate (2005-2016). There were similar patterns for cardiac arrhythmia, ischemic stroke, congestive heart failure, ischemic heart disease (IHD), and myocardial infarction (MI). Ambient PM2.5 concentrations and annual total CVD admission rates decreased across the period. However, the excess rate of IHD admissions associated with each IQR increase in PM2.5 in previous 2 days was larger in the after period (2.8%; 95%CI = 1.5%-4.0%) than in the during (0.6%; 95%CI = 0.0%-1.2%) or before periods (0.8%; 95%CI = 0.2%-1.3%), with similar patterns for total CVD and MI, but not other subtypes. CONCLUSIONS While pollutant concentrations and CVD admission rates decreased after emission changes, the same PM2.5 mass was associated with a higher rate of ischemic heart disease events. Future work should confirm these findings in another population, and investigate whether specific PM components and/or sources trigger IHD events.
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Affiliation(s)
- Wangjian Zhang
- Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, NY, USA
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, NY, USA
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY, USA
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Daniel Croft
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Stefania Squizzato
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Mauro Masiol
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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5
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Breen M, Xu Y, Schneider A, Williams R, Devlin R. Modeling individual exposures to ambient PM 2.5 in the diabetes and the environment panel study (DEPS). THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 626:807-816. [PMID: 29396342 PMCID: PMC6147059 DOI: 10.1016/j.scitotenv.2018.01.139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/20/2017] [Accepted: 01/15/2018] [Indexed: 05/22/2023]
Abstract
Air pollution epidemiology studies of ambient fine particulate matter (PM2.5) often use outdoor concentrations as exposure surrogates, which can induce exposure error. The goal of this study was to improve ambient PM2.5 exposure assessments for a repeated measurements study with 22 diabetic individuals in central North Carolina called the Diabetes and Environment Panel Study (DEPS) by applying the Exposure Model for Individuals (EMI), which predicts five tiers of individual-level exposure metrics for ambient PM2.5 using outdoor concentrations, questionnaires, weather, and time-location information. Using EMI, we linked a mechanistic air exchange rate (AER) model to a mass-balance PM2.5 infiltration model to predict residential AER (Tier 1), infiltration factors (Finf_home, Tier 2), indoor concentrations (Cin, Tier 3), personal exposure factors (Fpex, Tier 4), and personal exposures (E, Tier 5) for ambient PM2.5. We applied EMI to predict daily PM2.5 exposure metrics (Tiers 1-5) for 174 participant-days across the 13 months of DEPS. Individual model predictions were compared to a subset of daily measurements of Fpex and E (Tiers 4-5) from the DEPS participants. Model-predicted Fpex and E corresponded well to daily measurements with a median difference of 14% and 23%; respectively. Daily model predictions for all 174 days showed considerable temporal and house-to-house variability of AER, Finf_home, and Cin (Tiers 1-3), and person-to-person variability of Fpex and E (Tiers 4-5). Our study demonstrates the capability of predicting individual-level ambient PM2.5 exposure metrics for an epidemiological study, in support of improving risk estimation.
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Affiliation(s)
- Michael Breen
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States.
| | - Yadong Xu
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States
| | - Alexandra Schneider
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Ronald Williams
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States
| | - Robert Devlin
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC 27709, United States
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Baxter LK, Stallings C, Smith L, Burke J. Probabilistic estimation of residential air exchange rates for population-based human exposure modeling. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:227-234. [PMID: 27553990 PMCID: PMC6733390 DOI: 10.1038/jes.2016.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/27/2016] [Indexed: 05/25/2023]
Abstract
Residential air exchange rates (AERs) are a key determinant in the infiltration of ambient air pollution indoors. Population-based human exposure models using probabilistic approaches to estimate personal exposure to air pollutants have relied on input distributions from AER measurements. An algorithm for probabilistically estimating AER was developed based on the Lawrence Berkley National Laboratory Infiltration model utilizing housing characteristics and meteorological data with adjustment for window opening behavior. The algorithm was evaluated by comparing modeled and measured AERs in four US cities (Los Angeles, CA; Detroit, MI; Elizabeth, NJ; and Houston, TX) inputting study-specific data. The impact on the modeled AER of using publically available housing data representative of the region for each city was also assessed. Finally, modeled AER based on region-specific inputs was compared with those estimated using literature-based distributions. While modeled AERs were similar in magnitude to the measured AER they were consistently lower for all cities except Houston. AERs estimated using region-specific inputs were lower than those using study-specific inputs due to differences in window opening probabilities. The algorithm produced more spatially and temporally variable AERs compared with literature-based distributions reflecting within- and between-city differences, helping reduce error in estimates of air pollutant exposure.
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Affiliation(s)
- Lisa K Baxter
- National Health and Environmental Effects Research Laboratory, United States Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | | | - Luther Smith
- Alion Science and Technology Inc., Durham, North Carolina, USA
| | - Janet Burke
- National Exposure Research Laboratory, United States Environmental Protection Agency, Research Triangle Park, North Carolina, USA
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7
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Shmool JLC, Kinnee E, Sheffield PE, Clougherty JE. Spatio-temporal ozone variation in a case-crossover analysis of childhood asthma hospital visits in New York City. ENVIRONMENTAL RESEARCH 2016; 147:108-14. [PMID: 26855129 PMCID: PMC5552364 DOI: 10.1016/j.envres.2016.01.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/08/2016] [Accepted: 01/15/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND Childhood asthma morbidity has been associated with short-term air pollution exposure. To date, most investigations have used time-series models, and it is not well understood how exposure misclassification arising from unmeasured spatial variation may impact epidemiological effect estimates. Here, we develop case-crossover models integrating temporal and spatial individual-level exposure information, toward reducing exposure misclassification in estimating associations between air pollution and child asthma exacerbations in New York City (NYC). METHODS Air pollution data included: (a) highly spatially-resolved intra-urban concentration surfaces for ozone and co-pollutants (nitrogen dioxide and fine particulate matter) from the New York City Community Air Survey (NYCCAS), and (b) daily regulatory monitoring data. Case data included citywide hospital records for years 2005-2011 warm-season (June-August) asthma hospitalizations (n=2353) and Emergency Department (ED) visits (n=11,719) among children aged 5-17 years. Case residential locations were geocoded using a multi-step process to maximize positional accuracy and precision in near-residence exposure estimates. We used conditional logistic regression to model associations between ozone and child asthma exacerbations for lag days 0-6, adjusting for co-pollutant and temperature exposures. To evaluate the effect of increased exposure specificity through spatial air pollution information, we sequentially incorporated spatial variation into daily exposure estimates for ozone, temperature, and co-pollutants. RESULTS Percent excess risk per 10ppb ozone exposure in spatio-temporal models were significant on lag days 1 through 5, ranging from 6.5 (95% CI: 0.2-13.1) to 13.0 (6.0-20.6) for inpatient hospitalizations, and from 2.9 (95% CI: 0.1-5.7) to 9.4 (6.3-12.7) for ED visits, with strongest associations consistently observed on lag day 2. Spatio-temporal excess risk estimates were consistently but not statistically significantly higher than temporal-only estimates on lag days 0-3. CONCLUSION Incorporating case-level spatial exposure variation produced small, non-significant increases in excess risk estimates. Our modeling approach enables a refined understanding of potential measurement error in temporal-only versus spatio-temporal air pollution exposure assessments. As ozone generally varies over much larger spatial scales than that observed within NYC, further work is necessary to evaluate potential reductions in exposure misclassification for populations spanning wider geographic areas, and for other pollutants.
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Affiliation(s)
- Jessie Loving Carr Shmool
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, 100 Technology Drive, Ste. 350, Pittsburgh, PA 15219, USA.
| | - Ellen Kinnee
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, 100 Technology Drive, Ste. 350, Pittsburgh, PA 15219, USA.
| | - Perry Elizabeth Sheffield
- Icahn School of Medicine at Mount Sinai, DPM, 1 Gustave L. Levy Pl., Box 1057, New York, NY 10029, USA.
| | - Jane Ellen Clougherty
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, 100 Technology Drive, Ste. 350, Pittsburgh, PA 15219, USA.
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Breen MS, Long TC, Schultz BD, Williams RW, Richmond-Bryant J, Breen M, Langstaff JE, Devlin RB, Schneider A, Burke JM, Batterman SA, Meng QY. Air Pollution Exposure Model for Individuals (EMI) in Health Studies: Evaluation for Ambient PM2.5 in Central North Carolina. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2015; 49:14184-14194. [PMID: 26561729 DOI: 10.1021/acs.est.5b02765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Air pollution health studies of fine particulate matter (diameter ≤2.5 μm, PM2.5) often use outdoor concentrations as exposure surrogates. Failure to account for variability of indoor infiltration of ambient PM2.5 and time indoors can induce exposure errors. We developed and evaluated an exposure model for individuals (EMI), which predicts five tiers of individual-level exposure metrics for ambient PM2.5 using outdoor concentrations, questionnaires, weather, and time-location information. We linked a mechanistic air exchange rate (AER) model to a mass-balance PM2.5 infiltration model to predict residential AER (Tier 1), infiltration factors (Tier 2), indoor concentrations (Tier 3), personal exposure factors (Tier 4), and personal exposures (Tier 5) for ambient PM2.5. Using cross-validation, individual predictions were compared to 591 daily measurements from 31 homes (Tiers 1-3) and participants (Tiers 4-5) in central North Carolina. Median absolute differences were 39% (0.17 h(-1)) for Tier 1, 18% (0.10) for Tier 2, 20% (2.0 μg/m(3)) for Tier 3, 18% (0.10) for Tier 4, and 20% (1.8 μg/m(3)) for Tier 5. The capability of EMI could help reduce the uncertainty of ambient PM2.5 exposure metrics used in health studies.
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Affiliation(s)
- Michael S Breen
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Thomas C Long
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Bradley D Schultz
- U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Ronald W Williams
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Jennifer Richmond-Bryant
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Miyuki Breen
- Biomathematics Program, Department of Mathematics, North Carolina State University , Raleigh, North Carolina 27695, United States
| | - John E Langstaff
- Office of Air Quality Planning and Standards, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Robert B Devlin
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Alexandra Schneider
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology II , Neuherberg, Germany
| | - Janet M Burke
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27709, United States
| | - Stuart A Batterman
- Environmental Health Sciences, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Qing Yu Meng
- Department of Environmental Sciences, Rutgers University , New Brunswick, New Jersey 08901, United States
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Sheridan SC, Lin S. Assessing variability in the impacts of heat on health outcomes in New York City over time, season, and heat-wave duration. ECOHEALTH 2014; 11:512-25. [PMID: 25223834 DOI: 10.1007/s10393-014-0970-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 07/25/2014] [Accepted: 08/10/2014] [Indexed: 05/06/2023]
Abstract
While the impacts of heat upon mortality and morbidity have been frequently studied, few studies have examined the relationship between heat, morbidity, and mortality across the same events. This research assesses the relationship between heat events and morbidity and mortality in New York City for the period 1991-2004. Heat events are defined based on oppressive weather types as determined by the Spatial Synoptic Classification. Morbidity data include hospitalizations for heat-related, respiratory, and cardiovascular causes; mortality data include these subsets as well as all-cause totals. Distributed-lag models assess the relationship between heat and health outcome for a cumulative 15-day period following exposure. To further refine analysis, subset analyses assess the differences between early- and late-season events, shorter and longer events, and earlier and later years. The strongest heat-health relationships occur with all-cause mortality, cardiovascular mortality, and heat-related hospital admissions. The impacts of heat are greater during longer heat events and during the middle of summer, when increased mortality is still statistically significant after accounting for mortality displacement. Early-season heat waves have increases in mortality that appear to be largely short-term displacement. The impacts of heat on mortality have decreased over time. Heat-related hospital admissions have increased during this time, especially during the earlier days of heat events. Given the trends observed, it suggests that a greater awareness of heat hazards may have led to increased short-term hospitalizations with a commensurate decrease in mortality.
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Affiliation(s)
- Scott C Sheridan
- Department of Geography, Kent State University, Kent, OH, 44242, USA,
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10
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Baxter LK, Dionisio KL, Burke J, Ebelt Sarnat S, Sarnat JA, Hodas N, Rich DQ, Turpin BJ, Jones RR, Mannshardt E, Kumar N, Beevers SD, Özkaynak H. Exposure prediction approaches used in air pollution epidemiology studies: key findings and future recommendations. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:654-9. [PMID: 24084756 PMCID: PMC4088339 DOI: 10.1038/jes.2013.62] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 08/19/2013] [Indexed: 05/19/2023]
Abstract
Many epidemiologic studies of the health effects of exposure to ambient air pollution use measurements from central-site monitors as their exposure estimate. However, measurements from central-site monitors may lack the spatial and temporal resolution required to capture exposure variability in a study population, thus resulting in exposure error and biased estimates. Articles in this dedicated issue examine various approaches to predict or assign exposures to ambient pollutants. These methods include combining existing central-site pollution measurements with local- and/or regional-scale air quality models to create new or "hybrid" models for pollutant exposure estimates and using exposure models to account for factors such as infiltration of pollutants indoors and human activity patterns. Key findings from these articles are summarized to provide lessons learned and recommendations for additional research on improving exposure estimation approaches for future epidemiological studies. In summary, when compared with use of central-site monitoring data, the enhanced spatial resolution of air quality or exposure models can have an impact on resultant health effect estimates, especially for pollutants derived from local sources such as traffic (e.g., EC, CO, and NO(x)). In addition, the optimal exposure estimation approach also depends upon the epidemiological study design. We recommend that future research develops pollutant-specific infiltration data (including for PM species) and improves existing data on human time-activity patterns and exposure to local source (e.g., traffic), in order to enhance human exposure modeling estimates. We also recommend comparing how various approaches to exposure estimation characterize relationships between multiple pollutants in time and space and investigating the impact of improved exposure estimates in chronic health studies.
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Affiliation(s)
- Lisa K Baxter
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
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11
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Özkaynak H, Baxter LK, Dionisio KL, Burke J. Air pollution exposure prediction approaches used in air pollution epidemiology studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:566-72. [PMID: 23632992 DOI: 10.1038/jes.2013.15] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 10/24/2012] [Accepted: 11/09/2012] [Indexed: 05/20/2023]
Abstract
Epidemiological studies of the health effects of outdoor air pollution have traditionally relied upon surrogates of personal exposures, most commonly ambient concentration measurements from central-site monitors. However, this approach may introduce exposure prediction errors and misclassification of exposures for pollutants that are spatially heterogeneous, such as those associated with traffic emissions (e.g., carbon monoxide, elemental carbon, nitrogen oxides, and particulate matter). We review alternative air quality and human exposure metrics applied in recent air pollution health effect studies discussed during the International Society of Exposure Science 2011 conference in Baltimore, MD. Symposium presenters considered various alternative exposure metrics, including: central site or interpolated monitoring data, regional pollution levels predicted using the national scale Community Multiscale Air Quality model or from measurements combined with local-scale (AERMOD) air quality models, hybrid models that include satellite data, statistically blended modeling and measurement data, concentrations adjusted by home infiltration rates, and population-based human exposure model (Stochastic Human Exposure and Dose Simulation, and Air Pollutants Exposure models) predictions. These alternative exposure metrics were applied in epidemiological applications to health outcomes, including daily mortality and respiratory hospital admissions, daily hospital emergency department visits, daily myocardial infarctions, and daily adverse birth outcomes. This paper summarizes the research projects presented during the symposium, with full details of the work presented in individual papers in this journal issue.
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Affiliation(s)
- Halûk Özkaynak
- National Exposure Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC, USA
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